Provider Demographics
NPI:1386058667
Name:ZAUDTKE, MATTHEW MARVIN (DPT)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:MARVIN
Last Name:ZAUDTKE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 PIT RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-7830
Mailing Address - Country:US
Mailing Address - Phone:317-415-6045
Mailing Address - Fax:317-456-6045
Practice Address - Street 1:590 PIT RD
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-7830
Practice Address - Country:US
Practice Address - Phone:317-415-6045
Practice Address - Fax:317-456-6045
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05011732A2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic